Hydration and N-acetylcysteine in acute renal failure caused by iodinated contrast medium: an experiment with rats.
BACKGROUND
The involvement of nephrotoxic agents in acute renal failure (ARF) has increased over the last few decades. Among the drugs associated with nephrotoxic ARF are the radiologic contrast media whose nephrotoxic effects have grown, following the increasing diagnostic use of these agents.


METHODS
We evaluated the effect of iodinated contrast (IC) medium, administered in combination, or not, with hyperhydration or N-acetylcysteine (NAC), on creatinine clearance, production of urinary peroxides and renal histology of rats. Adult Wistar rats treated for 5 days were divided into the following groups: control (saline, 3 ml/kg/day, intraperitoneally [i.p.]), IC (sodium iothalamate meglumine, 3 ml/kg/day i.p.), IC + water (12 mL water, orally + IC, 3 ml/kg/day i.p. after 1 hour), IC + NAC (NAC, 150 mg/kg/day, orally + IC, 3 ml/kg/day i.p. after 1 hour) and IC + water + NAC.


RESULTS
IC medium reduced renal function, with maintenance of urinary flow. Hyperhydration did not reduce the nephrotoxic effect of the IC agent, which was observed in the group IC + NAC. The combination of hyperhydration and NAC had no superior protective effect compared with NAC alone. An increase in urinary peroxides was observed in the IC group, with NAC or water or the combination of both reducing this parameter. Histopathologic analysis revealed no significant alterations.


CONCLUSIONS
In summary, given 5 days previously, NAC was found to be more effective than hyperhydration alone in the prevention of contrast-induced acute renal failure.
Pinto
Carolina F
CF
School of Nursing, University of São Paulo, São Paulo - Brazil. vascocf@uol.com.br
Watanabe
Mirian
M
Vattimo
Maria de Fatina F
Mde F
D000111:Acetylcysteine / Q000494:pharmacology*; D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D000818:Animals; D003287:Contrast Media / Q000633:toxicity*; D003404:Creatinine / Q000378:metabolism; D005440:Fluid Therapy; D016166:Free Radical Scavengers / Q000494:pharmacology*; D007482:Iothalamate Meglumine / Q000633:toxicity*; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D008297:Male; D010545:Peroxides / Q000652:urine; D051381:Rats; D017208:Rats, Wistar
D003287:Contrast Media; D016166:Free Radical Scavengers; D010545:Peroxides; D003404:Creatinine; D000111:Acetylcysteine; D007482:Iothalamate Meglumine